How much rates vary
Facilitymedian $1,445 · 10th to 90th $603 to $7,762Professionalmedian $457 · 10th to 90th $81 to $794
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,862.09 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,862.09 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $4,168.69 | Professional | None | $602.56 | $602.56 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,584.89 Typical High $7,585.78 | Facility | None | $616.60 | $1,584.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $812.83 | Professional | None | $346.74 | $436.52 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,513.56 | Facility | None | $758.58 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,318.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,023.29 | Professional | None | $616.60 | $776.25 | $1,023.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,318.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,000.00 | Professional | None | $616.60 | $776.25 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $398.11 Typical High $707.95 | Professional | None | $70.79 | $398.11 | $707.95 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Facility | None | $645.65 | $676.08 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $776.25 | Professional | None | $537.03 | $588.84 | $776.25 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $1,096.48 | Professional | None | $380.19 | $549.54 | $1,096.48 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $302.00 Typical High $891.25 | Professional | 52 · Reduced service | $302.00 | $302.00 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $354.81 | Professional | 53 · Discontinued | $120.23 | $120.23 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $1,348.96 | Professional | 54 · Surgery only | $446.68 | $446.68 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $269.15 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $177.83 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $660.69 Typical High $1,202.26 | Professional | 50 · Both sides | $524.81 | $660.69 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $218.78 Median $275.42 Typical High $512.86 | Professional | 62 · Two surgeons | $218.78 | $275.42 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $77.62 Typical High $346.74 | Professional | 80 · Assistant surgeon | $56.23 | $77.62 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $61.66 Typical High $114.82 | Professional | AS · PA/NP assist | $48.98 | $61.66 | $114.82 |
Where Ohio sits
The same service costs 4.6 times more in Colorado than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $6,475DE $1,401
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.